# COVENANT CARE LONG BEACH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Catered Manor Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780672428
- **Authorized official:** CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (949) 349-1200

## Contact information

- **Practice address:** 4010 VIRGINIA ROAD, LONG BEACH, CA 90807-2627
- **Practice address phone:** (562) 426-0394
- **Practice address fax:** (562) 424-1529
- **Mailing address:** 120 VANTIS DR STE 200, ALISO VIEJO, CA 92656-2677
- **Mailing address phone:** (949) 349-1200
- **Mailing address fax:** (949) 349-1122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 940000049 | CA | Yes |

## Other

- **Enumeration date:** 10/06/2005
- **Last updated:** 08/14/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT06150J | — | CA |